• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.151-158
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• 2019

Background: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. Methods: A total of 107 extremely noncooperative intellectually disabled adult patients were analyzed. In all patients, deep sedation was performed using either propofol alone (group P) or using a combination of propofol and 0.2 mg/kg or 0.4 mg/kg ketamine (groups PK0.2 and PK0.4, respectively). The procedures were performed in the order of insertion of nasal cannula into the nostril, attachment of mouth gag, and mouth cleaning and scaling. The frequency of patient movement during the procedures, mean arterial pressure, heart rate, peripheral oxygen saturation, recovery time, discharge time, and postoperative nausea and vomiting were examined. Results: The three groups were significantly different only in the frequency of patient movement upon stimulation during single intravenous injection of propofol and scaling. Conclusion: For propofol deep sedation, in contrast to intravenous injection of propofol alone, prior intravenous injection of low-dose ketamine (0.4 mg/kg) is clinically useful because it neither affects recovery, nor causes side effects and can suppress patient movement and vascular pain during procedures.

• Herbal Formula Science
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• v.12 no.1
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• pp.195-208
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• 2004

Objective: This study was conducted to investigate the effects of Aconiti Tuber on the plasma IL-6 and $TNF-{\alpha}$ level in mice stimulated by intracerebroventricular(I.C.V.) Injection of Lipopolysaccharide(LPS). Method: 6 mice were assigned to each of the normal group, the control group, and the experimental group. In the normal group only saline was administered intragastrically, and in the control group LPS was injected intracerebro-ventricularly 1 hr after intragastric administration of saline. In the experimental groups (Aconiti Tuber 0.5g/kg, Aconiti Tuber 1.0g/kg, Aconiti Tuber 3.0g/kg) each sample was administered intragastrically to mice 1 hr prior to the stimulation by LPS I.C.V. Injection. To measure the plasma IL-6 and $TNF-{\alpha}$ level of mice, their blood samples were collected from retro-orbital plexus, immediately centrifuged at $4^{\circ}C$, and plasma was removed and stored frozen at $-83^{\circ}C$ for later determination of plasma IL-6 and $TNF-{\alpha}$. Result : 1. LPS I.C.V. Injection increased plasma IL-6 level significantly in a dose-dependent manner compared with normal group(P<0.01). The plasma IL-6 concentration reached a significant maximal level about 1 hr after LPS I.C.V. Injection(P<0.001). LPS I.C.V. Injection increased plasma $TNF-{\alpha}$ level significantly in a dose-dependent manner(P<0.05). The plasma $TNF-{\alpha}$ concentration reached a significant maximal level about 1 hr after LPS I.C.V. Injection(P<0.001). 2. Sample A group to which Aconiti Tuber(0.5g/kg) was administered intragastrically 1 hr prior to the stimulation by LPS I.C.V. Injection showed insignificant lower plasma IL-6 level in 1 hr than control group(P<0.0635), and sample B group (Aconiti Tuber 1.0g/kg) showed significant lower plasma IL-6 level in 1 hr than control group(P〈0.05), and sample C group (Aconiti Tuber 3.0g/kg) showed significant lower IL-6 plasma level in 1 hr than control group(P<0.01). 3. sample A group to which Aconiti Tuber(0.5g/kg) was administered intragastrically 1 hr prior to the stimulation by LPS I.C.V. Injection showed insignificant lower plasma $TNF-{\alpha}$ level in 1 hr than control group(P>0.05), and Both sample B(1.0g/kg) and sample C(3.0g/kg) groups showed significant lower $TNF-{\alpha}$ plasma level in 1 hr than control group(P<0.01). These data revealed that Aconiti Tuber might have the anti inflammatory effect by reducing the plasma IL-6 and $TNF-{\alpha}$ level in a dose dependent manner in mice LPS I.C.V. Injection.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.194-200
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• 1998

Background: Effect of nitric oxide on the hyperalgesia induced by inflammation is controversial. We attempted to find out the peripheral effects of nitric oxide (NO) on hyperalgesia induced by Freund's complete adjuvant (FCA) induced inflammation. Methods: Male Sprague Dawley rats were divided into three groups; control, low dose NG-nitro-L-arginine methyl ester (L-NAME, 500 ug), high dose L-NAME (5 mg). Inflammation was induced by injecting 0.1 ml of FCA intraplantarly, which shows typical hyperalgesia within twelve hours after injection and maintained for about one week. Drugs were injected 2 hours before, just before, and 3, 6, 9, 12 hours after the injection of FCA. Effect of L-NAME on hyperalgesia was assessed by measuring mechanical hyperalgesia and spontaneous pain for 3 days. Results: When injected at the site of inflammation, L-NAME caused dose dependent reduction of spontaneous hyperalgesia. Mechanical hyperalgesia was also reduced by high dose L-NAME (p<0.05). After systemic injection of high dose L-NAME in the back, no significant difference was noticed. Conclusions: This suggest that L-NAME reduces FCA induced hyperalgesia via peripheral action.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.92-99
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• 2007

Background: A correlation between a T-type voltage activated calcium channel (VACC) and pain mechanism has not yet been established. The purpose of this study is to find out the effect of ethosuximide and mibefradil, representative selective T-type VACC blockers on postoperative pain using an incisional pain model of rats. Methods: After performing a plantar incision, rats were stabilized on plastic mesh for 2 hours. Then, the rats were injected with ethosuximide or mibefradil, intraperitoneally and intrathecally. The level of withdrawal threshold to the von Frey filament near the incision site was determined and the dose response curves were obtained. Results: After an intraperitoneal ethosuximide or mibefradil injection, the dose-response curve showed a dose-dependent increase of the threshold in a withdrawal reaction. After an intrathecal injection of ethosuximide, the threshold of a withdrawal reaction to mechanical stimulation increased and the increase was dose-dependent. After an intrathecal injection of mibefradil, no change occurred in either the threshold of a withdrawal reaction to mechanical stimulation or a dose-response curve. Conclusions: The T-type VACC blockers in a rat model of postoperative pain showed the antihyperalgesic effect. This effect might be due to blockade of T-type VACC, which was distributed in the peripheral nociceptors or at the supraspinal level. Further studies of the effect of T-type VACC on a pain transmission mechanism at the spinal cord level would be needed.

• Journal of Pharmaceutical Investigation
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• v.29 no.3
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• pp.211-216
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• 1999

To evaluate the thrombolytic activity of streptokinase-dextran conjugate, a rat model of arterial thrombosis was used. Briefly, the femoral artery was exposed and a filter paper saturated with 70% $FeCl_3$ solution was placed around the femoral artery in order to stop the blood flow. Six minutes after the stop of the blood flow in the femoral artery, streptokinase $(10000{\sim}30000\;units\;per\;rat)$ or streptokinase-dextran conjugate $(5000{\sim}17000\;units\;per\;rat)$ was administered by i.v. bolus injection through the femoral vein. Then the blood flow in the femoral artery was monitored using a Doppler laser flow meter. The i.v. bolus administration of streptokinase could not restore the blood flow in the femoral artery in the dose range of $10000{\sim}30000$ units per rat. The i.v. bolus administration of streptokinase-dextran conjugate could restore the blood flow in the femoral artery in the dose range of $5000{\sim}17000$ units per rat. A good correlation between the dose of streptokinase-dextran conjugate and the total thrombolytic effect was observed. In addition, the lag time between the injection of streptokinase-dextran conjugate and the restoring of the blood flow was decreased as the i.v. dose of streptokinase dextran conjugate increased. These results show the superior beneficial effect of streptokinase-dextran conjugate compared with the unconjugated streptokinase with respect to the elongation of thrombolytic activity, the administration method (single injection versus continuous infusion), and the reduced dose necessary for a equivalent thrombolytic effect.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.42-47
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• 1997

Background : This study was designed to evaluate the continuous effects of single intravenous injection of antiemetics on nausea and vomiting during continuous morphine injection for postoperative pain control. Methods : Prior to the study, we divided patients into two major groups according to the type of surgery performed intra-abdominal(Open: O) and non intra-abdominal(Close: C). When patients regained orientation after routine general anesthesia, enflurane-$O_2-N_2O$, we injected bolus dose of morphine and started continuous injection of morphine for postoperative pain control(Group I; Control). After bolus injection and just before continuous injection, we injected single dose of droperidol(Group II) or ondansetron(Group III). Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 10 minutes, 4, 8, 16, 24, 36 hours after continuous morphine injection. Results : The pain score of group III was lower than group II(10 min.) and group I(24, 36 hours) in the open group. Symptom-therapy score of group III(10 min., 4, 24 hours) and group II(10 min.) were lower than group I in the open group. In the close group, symptom-therapy score of group III(8 hours) was lower than group I. Conclusions : Single intravenous injection of antiemetics have a tendency of lowering symptom-therapy score for 36 hours in spite of their relatively short elimination half-life.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.226-231
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• 2001

We investigated the effects of interactions of medetomidine and atipamezole on electroencephalography (EEG) in seven dogs. The dogs were sedated with medetomidine at dose of 30$\mu\textrm{g}$/kg, IM. Atipamezole was injected 15 min later at dose of 30$\mu\textrm{g}$/kg, IV. Recording electrode was positioned at Cz, which was applied to International 10-20 system. Heart rates, arterial blood pressures and behavioral changes were also measured. EEG was recorded in 6 stages(S1: before medetomidine injection, S2: prior to head-down movement after medetomidine injection, S3: 5 minutes after medetomidine injection, S4: 10 minutes after medetomidine injection, S5: 15 minutes after medetomidine injection, S6: prior to head-up movement after atipamezole injection), and heart rates and arterial pressures were recorded at S1, S5 and S6. All results were compared with those of control(S1). After medetomidine injection, the power spectra of EEG were gradually decreased and those of the frequency over 13 Hz were significantly decreased(p<0.05), which were still in the significantly decreased state after atipamezole injection. In the band powers (Band1; 1-2.5 Hz, Band2; 2.5-4.5 Hz, Band3; 4-8Hz, Band4; 8-13 Hz, Band5; 13-20 Hz, Band6; 20-30 Hz, Band7; 30-50 Hz, Band8; 1-50 Hz), band 1, 2, 3, 4, 8 were not significantly changed in any stages. Band 5, 6, 7 were significantly decreased in S 3, 4, 5, 6. That is, medetomidine affects the frequency band over 13 Hz on EEG, and atipamezole does not restored the decreased band powers until dogs showed head-up movement.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.247-255
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• 2005

The purpose of this study is to evaluate the effect of botulinum toxin type A on masseter muscle atrophy and the extent of masseter muscle affected from the injection site in relation to injection dose, with and without occlusal splint therapy through computed tomographic measurement. 32 volunteers were divided into four groups - group 25U (injection dose of 25 unit), group 25Us (injection dose of 25 unit with occlusal splint), group 35U (injection dose of 35 unit), group 35Us (injection dose of 35 unit with occlusal splint). Each group consisted of 8 people. 3 positions (position 1, 2, 3 - 10mm, 20mm and 40mm from the inferior border of the mandible, respectively) were selected for the evaluation of the masseter muscle change. The following results were obtained. 1. The thickness and the cross-sectional area of the masseter muscle had reduced in all groups except for the right side thickness at position 3 of group 25U and group 25Us, and the right side thickness as well as the left side cross-sectional area at position 3 of group 35Us. In group 35Us, the thickness and the cross-sectional area of the masseter muscle had reduced significantly in all positions (P < 0.05). 2. There was no significant difference in the masseter muscle change between the injection dose of 25unit and that of 35unit. 3. The groups with occlusal splint showed greater reduction of the masseter muscle thickness than the other groups (P < 0.05). From the above results, botulinum toxin type A injection together with occlusal splint therapy in the treatment of masseter muscle hypertrophy would be clinically effective.

• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.61-71
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• 2016

Purpose: This study was designed to evaluate the comparison between the subjective and the objective evaluation of pain control effect in masticatory muscle pain depending on time and dose change. Methods: The patients were recruited to this study and diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Experimental group were divided into three groups; saline injection group (n=10), morphine 1.5 mg injection group (n=10), and morphine 3.0 mg injection group (n=10). Evaluation list was the subjective pain evaluation (visual analogue scale, McGill pain questionnaire) and the objective pain evaluation (pressure pain threshold [PPT], pressure pain tolerance [PTO]). The subjective and the objective pain evaluation were performed at the times of just before injection, 10 minutes, 30 minutes, 1 hour, 24 hours, and 48 hours after injection. Then, data were statistically analyzed. Results: The results were as follows: 1) There is no statistically significant difference between the results of the subjective and the objective pain evaluation with regard to the short-term (within 1 hour) analgesic effect of morphine sulfate. 2) However, after 1 hour of injection, while the subjective pain evaluation score still decreased, the objective pain evaluation didn't show significant changes in PPT and PTO (1 hour, p<0.05; 24 hours, p<0.01; 48 hours, p<0.001). 3) In comparison to changes in the dose, the McGill pain questionnaire was the most statistically effective method among the subjective pain evaluations (1.5 mg, p<0.05; 3 mg, p<0.01). Conclusions: Therefore, it was revealed that the subjective pain evaluation was more effective to evaluate long-term pain control, and that the McGill pain questionnaire could be an effective way to evaluate pain control depending on dose changes. It requires further investigations with time and dose extension.

• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.333-336
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• 2002

This experiment was carried out to investigate the optimal dose of intravitreal gentamicin that decreases intraocular pressure effectively and minimizes complications in dog. After inhalation anesthesia, gentamicin was injected intravitreally into the left eyes at doses of 10, 15 and 20 mg with 1 mg dexamethasone, respectively. Sterilized isotonic saline and dexamethasone mixture into the right eyes for control. Six dogs were used in each group. Intraocular pressures were measured using applanation tonometer(Mentore, Tono-Pen) until 5 months after injection of gentamicin. Ocular examinations were performed using direct ophthalmoscopy. The ocular volumes of both eyes were measured. Intraocular pressures of eyes injected with 10. 15 and 20 mg of gentamicin were decreased significantly compared with control eyes. Severe corneal opacity and neovascularization occurred in 20 mg treated group. Intraocular hemorrhage was observed in 3 dogs of 20 mg treated group. Ocular volume was significantly decreased(p <0.05) in 20 mg treated group, compared with 10 and 15 mg treated group. It is considered that intravitreal gentamicin injection at dose of 10 mg or 15 mg decrease intraocular pressure effectively and minimize complications such as corneal opacity, hyphema and phthisis bulbus.